Assessing the range of social interaction and performance situations that patients with social anxiety disorder (SAD) may fear or avoid.
Evaluating the severity and breadth of social anxiety symptoms.
Monitoring response to treatment (medication or behavioral therapy) in patients with SAD.
Evaluating both anxiety (fear) and avoidance components of social anxiety.
Section 2
Formula & Logic
Scoring Logic
The LSAS consists of 24 items, each rated for "Fear/Anxiety" (0-3) and "Avoidance" (0-3). The total score is the sum of all 48 ratings, ranging from 0 to 144.
Severity Cutoffs
Score 30–55
Mild Social Anxiety
Score 55–65
Moderate Social Anxiety
Score 65–80
Marked Social Anxiety
Score 80–95
Severe Social Anxiety
Score > 95
Very Severe Social Anxiety
Section 3
Pearls/Pitfalls
Pearls for Practice
Differentiate between "Performance" anxiety (e.g., public speaking) and "Social Interaction" anxiety (e.g., meeting strangers). The LSAS covers both.
Note the "Fear vs. Avoidance" gap—some patients may still force themselves into situations (Low Avoidance) while experiencing extreme distress (High Fear).
Consider comorbid AUD—many patients with SAD use alcohol as "social lubricant" to lower LSAS-related distress.
Section 4
Next Steps
Therapeutic Targets
01
Score < 30: Minimal SAD symptoms. No clinical intervention typically required.
02
Score 30–60: Consider CBT with focus on social exposure or SSRI therapy (e.g., Sertraline, Paroxetine).
03
Score > 60: High functional impairment likely. Combined psychotherapy and pharmacotherapy is strongly recommended.
04
Relapse Prevention: Continue monitoring LSAS scores even after symptom improvement to ensure sustained remission.
Section 5
Evidence Appraisal
Primary Reference
Social Phobia
Liebowitz MR • Modern Problems of Pharmacopsychiatry. 1987;Vol 22. pp. 141-173. The seminal paper introducing the scale for clinical evaluation of social phobia.
Section 6
Literature
Dr. Michael Liebowitz
Developed by Michael Liebowitz, a psychiatrist and founder of the Anxiety Disorders Clinic at the New York State Psychiatric Institute. He was a pioneer in identifying Social Anxiety as a distinct, treatable psychiatric condition rather than just "extreme shyness."
